Is The Keto Diet Safe for People with Prediabetes and Type 2?

What dinner might look like on a Keto Diet

What is the Keto Diet?

Unless you’ve been living in a yurt in Mongolia for the last few years, chances are you’ve been hearing magical stories about the Keto diet. How followers dropped tons of weight, seemingly effortlessly, all while eating steak and butter!

You may have even rolled your eyes, convinced that it sounds too good to be true. Well, you’d be wrong! Or at least not entirely right. Let me explain…

The Keto Diet has been around since the 1920s. In fact, it was a medically approved protocol prescribed for children with hard to control (refractory) epilepsy in the early 1920s and 1930s. In the mid-1990s, it began to gain traction again thanks to the publicity efforts of the Charlie Foundation, the founding of which was featured in an episode of NBC’s Dateline, and a Made-for-TV movie starring Meryl Streep.

How does the Keto Diet work?

The Keto Diet works by severely limiting carbohydrate intake to approximately 20-50g per day. Some versions of the diet suggest capping your daily carb intake at no more than 20 grams per day. With the removal of carbohydrates, the fat then becomes the primary food source of this diet with what is often described as “adequate” protein making up the rest. 

The drastic reduction in carbohydrates and the subsequent drop in glucose production (the body’s preferred fuel) drives down insulin levels, eventually leading your body into a state of ketosis. During ketosis, the body is forced to burn fat for fuel rather than carbohydrates. The fuel that is produced is referred to as a ketone body or ketones. This is what is referred to as the “ketogenic effect.” You may also see this referred to as being “fat adapted.”

It’s important to note that the ketogenic effect is a normal process and generally safe for most individuals. The production of ketone bodies is not related to the dangerous state of ketoacidosis.

Vs. Low-Carb

So what’s the difference between a Low-Carb diet and Keto? Generally speaking there isn’t a hard and

What dinner might look like on a Keto Diet

What dinner might look like on a Keto Diet

fast definition of a Low-Carb diet. Most diets claiming to be Low-Carb probably seem similar to Keto.

They are reducing carbs, increasing fat, and often increasing protein as well. The main difference is that on a Low-Carb diet you aren’t likely to remain in ketosis as steadily as you would doing Keto. This is because Low-Carb diets often allow greater flexibility in the food sources and the carb count.

Most Low-Carb diets use a more lenient calculation called “Net Carbs.” Net Carbs are determined by subtracting the amount of dietary fiber from the total carb count. Low-Carb diets often permit up to 100 grams of carbohydrate a day, while the Keto diet can be anywhere from 20-50 grams, with many recommending 20 grams as your max!

Vs. Paleo

Paleo is also often referred to as the Carnivore Diet or the Caveman Diet. It relies on protein as its mainstay and embraces fat as an optimal fuel source. What Paleo avoids at all costs is modern, processed food. Food that our caveman ancestors wouldn’t recognize as food.

With Paleo, the goal is to create an eating style that mimics that of Paleolithic hunter-gatherers. The main argument for this is that after 100,000 years or more our bodies are best adapted for this style of eating – unlike grain-based, processed foods like bread and instant potatoes that have developed only over the last 10,000 years or so. 

So with Paleo, you lose all grains, legumes (beans), processed sugar, processed foods, and almost all sources of dairy. Instead, meat, fish, eggs, fruits, berries, and vegetables comprise the diet. 

Vs. Atkins®

The Atkins® Diet and later the popular South Beach Diet are both forms of Low-Carb diets. The primary difference between Atkins® and Keto is that Keto prefers to limit protein in favor of healthy fats. Whereas Atkins® places no such limits on your protein consumption.

The Atkins® Diet was developed in the 1960s as a short-term weight loss solution. The Keto Diet, on the other hand, was developed to address a medical need – epileptic seizures – and more recently a host of metabolic disorders. 

Atkins® also focuses on Net Carbs when calculating your carbohydrate intake and runs its followers through a 4-stage process where you begin with a significant carb reduction and slowly loosens those restrictions as you reach your target weight. Keto, on the other hand, is generally fairly steady in its approach to carbohydrate restriction making it slightly more of an eating style than a hardcore restriction diet.

Benefits of the Keto Diet

In the short term, taking a Keto approach to eating has been shown to help people with type 2 diabetes better control their blood sugar. In addition to the effect on blood sugar, those following a ketogenic diet almost invariable lose weight which has a positive impact on a variety of other health factors such as high blood pressure, arthritis, and depression.

Many followers of the Keto diet also report better, deeper sleep and greater time spent in REM sleep phase which is particularly beneficial. And considering the fact that American’s are chronically sleep-deprived, this could be a great side benefit of the ketogenic effect. Sleep promotes feelings of well-being, mental clarity, healing, reduction in inflammation, and of course, weight loss.

We can’t overlook the obvious benefit and the main reason most people adopt a Keto eating style – and that’s weight loss. For people with prediabetes and type 2 diabetes, dropping excess weight can reduce your risk of developing type 2 diabetes. Or, if you already have that, reduce your risk of possible complications. When you combine that with the studies, although limited, that seem to show A1C levels dropping for Keto followers this may seem like a no-brainer for you. 

But keep reading…

Risks Associated with Keto

Due to the high fat intake promoted on Keto, some studies show some people see and initial increase in cholesterol levels. But those levels appear to drop off after a few months. But there is no long-term research which sheds light on the effects over time on diabetes and high cholesterol. If you have a history of high cholesterol or heart disease, or you’re already taking a statin or other cholesterol-lowering drug you’ll need to clear your Keto plan with your care team first.

People with kidney disease need to be cautious because most people tend to overeat protein when doing the Keto diet. This increase in protein can put an added strain on your already taxed kidneys so proceed with extreme caution and absolutely consult your primary care team before starting any type of Low-Carb or High-Protein diet. 

The keto diet is not recommended at all for people with type 1 diabetes due to the aforementioned risk of ketoacidosis.

Get Your Free “Keto Quickies” Guide

We put together a quality Keto resource on the web guide for you to further your knowledge. Download it here.


The Keto diet may be a good option for people with prediabetes and type 2 diabetes who are looking to lose weight and reap the benefits that weight loss can provide. So long as they have no other health concerns that might make this diet a greater risk. 

Because of the extreme nature of this eating style, I would urge anyone considering Keto to speak with your primary care provider before you commit. Everyone’s health is different and only you and your care team know your exact situation and where your concerns might outweigh this diet’s benefits.

The studies showing both the positive and negative effects of following a ketogenic diet are far from robust. As we continue to get more data, create better studies, and more long-term follow up, we may well see the Keto diet emerge as a powerful tool to treat a variety of metabolic disorders. But from a scientific standpoint, we’re just not there yet. 

So if you’re planning to start this way of eating, make sure you’re safe to do so.

Share on facebook
Share on twitter
Share on pinterest
Share on linkedin
Share on email

6 Comments on “Is The Keto Diet Safe for People with Prediabetes and Type 2?

dottie bitterly
August 21, 2019 at 6:57 am

The keto diet is not recommended at all for people with type 1 diabetes due to the aforementioned risk of ketoacidosis.

I loved this article explaining the different diets.
but this above statement doesn’t make sense to me.
2 different things as you mentioned so why this statement?

hugs, dottie

Theresa Garnero
August 21, 2019 at 12:07 pm

Hi Dottie. Happy to clarify but I’m not sure which statement didn’t make sense. Please let me know! Thanks, Theresa

Keto With Kelly
November 6, 2019 at 12:23 am

This is the amazing valuable diet plan blog, it really helps to understand about keto better.

Fitness health Forever
April 22, 2020 at 7:57 am

Thank you for sharing this lovely post. have a good day.

July 6, 2020 at 5:54 am

I think the reason itself is that people have not understood the keto diet itself. They have took this diet to real extreme. It’s not that you have to cut down the card to its bare minimum. Carbs are the pure source of energy and gives you the required glucose level when needed. However, people usually plan keto diet in such a way that they include little to no carb in it. On thing that we should keep in mind is that persistent is the only way for long term results. Taking such diet to its extreme is not going to help anyone. You may lose weight in short term, but in the long term, you may gain more fat that before.
The information above can help you to be more consistent in the process. I am thankful to the writer for sharing such valuable information.

Quinn Vivien
October 21, 2020 at 6:45 am

Reducing CHO intake with an LCD is effective in reducing body weight and, in patients with type 2 diabetes, improving glycemic control, with a stronger effect with a very low carb diet (KD). However, LCD and KD may not be appropriate for all individuals. Especially in patients with type 2 diabetes, it is necessary to balance the potential increase in cardiovascular risk because of the unfavorable lipid profile observed with KD with the benefits deriving from weight loss and improvement of glycemic control. Moreover, long-term compliance with low-CHO diets is still an issue. In type 1 diabetes, there is no present evidence that an LCD or a KD can delay or prevent the onset of the disease. These diets have the potential to improve metabolic control, but caution is needed because of the risk of DKA, of worsening the lipid profile and, in children, the unknown impact on growth.


Leave a Reply

Your email address will not be published.